Does a Richland Co. EMS policy contribute to patients' deaths? - @ JEMS.com


Does a Richland Co. EMS policy contribute to patients' deaths?


 
 

Dan Tordjman | | Thursday, April 24, 2008


JEMS.com Editor's Note: A. J. Heightman weighs in on this controversy in "Sensible or Senseless?"

COLUMBIA, S.C. -- If we told you there was an ambulance policy in the Midlands that could put lives at risk, you might find it hard to believe. But what we found could shock you.

"911, what's your emergency?" began the call for help from Mary Myers. Her husband George was short of breath.

"George, are you ok?" you can hear Mary ask her husband on the tape. "Just send help in a hurry," she told EMS.

Columbia firefighters and Richland County EMTs show up at the Myers home, but George had stopped breathing.

Yet ten minutes later, Mary says EMS still hasn't taken her husband to the hospital. The ambulance was still parked outside her home.

Within minutes Columbia firefighters arrive, and moments later Richland County EMS. Then, while being put on a stretcher, George Myers stops breathing.

Columbia firefighters offer to help EMS, but instead the EMTs call for their own backup -- another ambulance.

"I don't know how long it took, but it seemed like forever," says Mary.

All the while, Mary notices the firefighters outside her home are just standing and watching while EMTs work on her husband George.

Later at the hospital, doctors tell Mary George is dead. "I don't know what happened, but he's gone," Mary said.

"After 29 years of seeing a lot of terrible things in my career, I found it frustrating and I really couldn't do it anymore," says Scott Fulkerson.

Fulkerson retired from the Columbia Fire Department last month as one of its highest-ranking field officers. But all along, stories like Myers' made him think.

"People's lives are being lost and I can't stand by and watch it anymore," says Fulkerson.

Now, Fulkerson is breaking his silence, giving voice to a six-month WIS News 10 investigation.

"I have a lot of guilt in my heart right now. I had to wait until I was retired to do this. I guess most of it is fear of retaliation," said Fulkerson.

During the investigation we listened to the accounts of several current firefighters who were afraid to speak on camera. But they all said the same thing -- citizen lives are being put at risk because of a Richland County EMS policy.

"When you know there's something wrong and you don't do anything to fix it, I think that's criminal," says Fulkerson. "I find it obscene to allow this to happen, to allow patients, to allow victims out there, citizens out there, not to have the best they can have is wrong."

The guideline, in short, doesn't allow city firefighters to work inside or drive county ambulances.

In the most serious cases, EMS instead waits for its own backup crew to assist and drive the ambulance.

That means, in emergency situations like Myers', firefighters on scene have to step aside, watch and wait until EMS backup arrives.

That just doesn't make sense to Myers.

"I said 'what are you doing, why are you not leaving?'" she recalls.

Those are the same questions Fulkerson constantly found himself asking. In one instance, he says his firefighters got called to the scene of a child drowning.

They were about to drive the ambulance to a hospital when EMS said no, policy didn't allow for it.

"They were having to wait for their supervisor. Well I'm holding a 9-year-old cousin of this child that's drowned, and telling him they're leaving soon. And he's sitting there telling me, 'I don't want him to die,'" says Fulkerson.

In that case, Fulkerson says "the golden hour was shot. Her child died."

There are a handful of other incidents listed in a study done by Columbia firefighters. WIS obtained it through the South Carolina Freedom of Information Act.

Our request gave the city of Columbia 15 working days by law to get it to us -- the report arrived two months later.

Inside, WIS uncovered firefighter concerns about their relationship with EMS. While the report doesn't draw any clear link between the delays and patient deaths, firefighters indicate they weren't allowed to do all they could to save a life.

In the case of a child drowning victim, the report states firefighters stood by for more than 20 minutes before EMS transported him to the hospital.

The Myers' case is also cited. Here, it took nearly ten minutes.

In every incident the report shows the delay was caused by the wait for EMS backup, even though Columbia Fire was on scene and could've driven to the hospital.

WISNews 10:Were any lives lost because of this policy?

Fulkerson:I can't definitely say there was a life lost, but I know in my heart the chances of survival was reduced greatly.

Trying to explain the logic behind its policy, George Rice with Richland County EMS agreed to talk to us -- or rather, show us why only EMTs could perform in and drive its ambulances.

"I'd like to walk you through and let you see how hard the skills are that our paramedics have to do," Rice told WIS News 10's Dan Tordjman.

The demonstration revolves around precision.

"Imagine driving down the road riding in an ambulance trying to do this," said Rice during the demonstration. "We have a live needle in the back of the truck, so if somebody got stuck by that needle, that would be a big problem."

To reduce that risk, Rice says his drivers get formal training and know how to communicate with paramedics in the back.

"It's like an orchestra," Rice says. "They're asking what's going on in the back, so they're able to control the ambulance and keep it stable."

But those concerns don't seem paramount in other Midlands counties.



In fact, every single surrounding EMS agency allows area firefighters to ride in and operate county ambulances.

Firefighters help as trained first responders. Columbia firefighters get the same training, but Richland County EMS insists that's not enough.

"Would they be interested in taking the additional risk of having one of our employees, one of our paramedics or EMTs, go into a fire ground operation, and start handling a fire hose or start working within the fire ground? Would they be willing to take that risk?" asks Rice.

At least one veteran firefighter was willing to take a risk of his own, questioning policy in the hopes that'll it bring Columbia Fire and Richland County EMS together.

Meanwhile, the Myers family is sharing their story, one they hope makes a difference.

"It won't help George, but maybe it'll help someone else. If they don't have to wait for another ambulance to come to take people to the hospital when they need to go," says Mary.

The story doesn't end there.

When WIS News 10 first started investigating this policy, Myers says EMS actually called her. On Friday, we'll tell you why.

We'll also take a closer look at Columbia Fire's official stance on the issue, and whether they'd be willing to do any additional training to assist EMS in ambulances.



But it's not even an option, according to Richland County Administrator Milton Pope.

After we started this investigation, Pope met with Columbia City Manager Charles Austin.

Pope tells us this week they agreed "nothing would change" and that for now the "wait-for-back-up" rule is "the most prudent policy."

Count on WIS News 10 for a lot more on this story in the coming days. Click here to see the original story. And click here to read an update.




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